![]() ![]() This lead to widespread calls to reduce the use of the newer medicines, and about 40% of states did so through policies that discouraged doctors from such use. ![]() One of the heavily publicized findings from the report was that the newer medicines didn’t seem to be any more effective than the older, cheaper, generic ones. In 1999, the National Institute of Mental Health funded a $42.6 million study called Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) comparing the effectiveness of one first generation antipsychotic (perphenazine) with all of the atypicals currently available in the U.S. Costs for these drugs, however, have as a consequence gone up. As a result, the atypicals quickly dominated the market, accounting for 90% of prescriptions. This serious side effect can stigmatize patients, leading them to stop taking effective medicines.īy the 1990s, drug companies had developed a new class of drugs called atypical antipsychotics that had fewer side effects, including TD. These drugs were effective, but after prolonged exposure many patients developed a side effect called tardive dyskinesia (TD)-jerky, involuntary facial or limb movements that could become severe and permanent. In the 1950s, researchers created a class of drugs called "typical" antipsychotics, which were one of the first treatments for schizophrenia. Take antipsychotics, one of the biggest drug classes in Medicaid. ![]() Yet such "one-size-fits all medicine" will likely increase under centralized CER. The same meds that work well for some patients may not work for others indeed they may make others worse. Some cheaper medicines may become first-line treatments, even if they offer worse outcomes for many patients.īefore we deny patients access to expensive new medical innovations, we need to understand CER’s limitations and learn how to overcome them. Fiscal pressures mean that sooner or later CER will drive reimbursement decisions for public programs like Medicare and Medicaid. Thanks in part to cheerleading from the White House, Congress is poised to pass health care reform legislation that devotes dozens of pages to creating new agencies, commissions and standards for conducting comparative effectiveness research (CER) in the hopes of cutting billions in unnecessary spending.ĬER is a good idea but can be harmful when done through centralized methods. President Obama once famously quipped, "If there’s a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that’s going to make you well?" Increasing the use of cheaper, but still effective treatments, medicines and procedures is one of the central ideas behind a new science called comparative effectiveness research. ![]()
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